The Thyroid and The Entirety E-Book

Azin Farid Sandberg

• Herausgeber: Books on Demand
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 335

Veröffentlichungsjahr: 2023

Beschreibung

This book is written for interested doctors as well as patients who want to learn more about the thyroid gland and the causes behind thyroid dysfunction. It takes us on a journey through the body and explains how the thyroid gland works and interacts with different organs. It also gives the patient an understanding of their disease as well as knowledge and important tools with which to motivate their doctor. The book also addresses how nutrition, environment and lifestyle factors affect the thyroid gland and adrenal gland function. Dr. Azin Sandberg's long experience in the treatment of thyroid diseases is presented in an easily accessible way together with informative patient cases. The latest treatment methods and published studies in the field are also presented here. In the book, the author also talks about her own thyroid disease and experiences dealing with the Swedish healthcare system. How by combining classical school medicine with the knowledge of the body's need to stabilize minerals, vitamins and hormones, she managed to cure herself. This is a book that the author herself wished she had received in her hand when she was sick. Dr . Sandberg is a licensed physician and specialist in family medicine with more than 23 years of experience in healthcare. In recent years, she has been more focused on, and treating patients with hormonal problems, especially thyroid diseases.

Leseprobe

Love and wisdom are the key to our happiness

First, I would like to thank our creator who gives us life and the

opportunity to develop ourselves

No words can thank you enough, my wonderful husband. This book

belongs to you as much as to me. You have patiently helped me

from idea to finished book.

I want to thank my parents for their constant support, my father-in-

law and my siblings who always provide help when we need them.

I thank my fantastic patients who have helped me become who I am

today.

A big thank to all co-workers editor, J. Sandberg, translator Nilo

Rezai, proof reader Ola Linell who patiently and carefully translated

the book from the original Swedish to English, and Behnaz Zarrin

for her fantastic illustrations. Thank you all, you made this work

possible.

To my dearest A.& E.

Thank you for being in my life!

A few words to the reader

The information in this book is based on several years of experience. Most of the content is also documented in published studies with references at the end of each chapter. The purpose of the book is to provide information and spread knowledge. All treatments and advice mentioned in this book should be viewed as recommendations only and not as medical advice. Treatment should solely be carried out in consultation with an experienced physician.

This book is not a medical manual and cannot replace medical advice and treatment from a qualified physician. Responsibility for any consequences or complications that may arise lies entirely with the treating party.

All the names of the patients mentioned in this book have been changed except for one. This was done with her permission and approval as this case has already been published in media.

The images and figures in this book are in color when the book is ordered via BoD but may appear in black and white depending on the printer's agreement with BoD.

Table of contents

Introduction

Preface

Chapter 1

.

My Story

Chapter 2.

Food and Inflammation

Chapter 3.

Anatomy and physiology of the thyroid gland

Chapter 4

.

Minerals Part 1. Cu, Zn, Fe

Chapter 5.

Minerals Part 2. Se, Mg, Mn, Na, K, Ca, B

Chapter 6.

Vitamins Part 1. A, B, C, D, E, K

Chpater 7.

Vitamins Part 2. B12

Chapter 8.

Halogens

Chapter 9.

Iodine

Chapter 10.

Symptoms & Diseases Related to Hypothyroidism

Chapter 11

.

Thyroid Dysfunction & Autoimmunity

Chapter 12.

Diagnostics and treatment

Chapter 13.

Case Study- NDT

Chapter 14.

Which samples should be analyzed

Chapter 15.

Adrenals, stress and HPAT Axis

Chapter 16.

Fibromyalgia and CFS/ME

Chapter 17.

Fatty Acids, Omega 3 & Omega 6

Chapter 18.

Recipes

Afterword

Glossary

"If I had undergone the conventional treatment that the healthcare offered, I would, early on, have become a very sick and prematurely retired doctor with no hope of getting back to work."

Dr. Azin Farid Sandberg M.D.

Introduction

My interest in thyroid diseases and other endocrine organs began early as several of my patients and close relatives were not feeling well despite the recommended standard treatment. It wasn't long before I became very ill with Hashimoto's thyroiditis, an inflammatory thyroid disease, with an impact on multiple organs. I believe that my path to healing, as well as both being a doctor and a patient in our healthcare system, has given me a great understanding and experience which has enabled me to help others in a similar situation.

This book was mainly written in 2015 but has been updated with new texts and information during 2019-2020. Published in Swedish 2021, translated and updated in English 2022.

This book is the result of years of experience and hard work. It is written for both patients and treating physicians. It's a book I wished I had in my hand when I was sick myself.

The book is not only about the thyroid gland and how our trillions of cells depend on thyroid hormones, instead it takes us on a journey through the body and explains how the thyroid interacts with different organs.

The Purpose of the Book

Raise the issue and spread knowledge about the thyroid problem and its root causes.

Thyroid dysfunction is not a single disease, and monotherapy rarely provides sufficient effects.

Increase knowledge about nutrition, minerals, vitamins, and their connection with the thyroid gland.

Information about new methods of treatment when the standard treatment does not work.

Preface

My purpose of this book is to raise the issue of the thyroid problem and to suggest alternative treatments as I have come across many who are suffering in vain. This is a result of insufficient knowledge about the connection between thyroid and many inflammatory diseases.

A large number of patients have symptoms and disease profiles which may have a similar root cause. Many of these patients haven’t received the proper treatment which is why this problem must be raised.

Almost half a million people are living with a thyroid diagnosis in Sweden today. The unrecorded numbers are most likely much larger, as many suffer from these diseases without having a correct diagnosis. According to the Swedish Thyroid Association “Sköldkörtelförbundet”, 475 000 people were medicated for thyroid diseases during 2018.

I would like to contribute with the knowledge and experience that I have acquired as both patient and doctor to further enhance the understanding of the thyroid problems.

I wonder if the healthcare system and the healthcare professionals have made it too easy on themselves. Doctors mostly rely on the test results and don’t always act according to the given symptoms. The healthcare system interprets it as if the patient doesn’t have any thyroid problems if the blood results are within the normal reference range, even though the patient suffers from related symptoms. In other words, if the blood work looks fine then the patient should be feeling fine as well.

Sadly, there isn’t enough research on thyroid diseases. Neither is there sufficient research on complementary or alternative treatments for patients who do not respond to standard treatments such as Levothyroxine*. Instead, diabetes has been in focus when it comes to diseases of the endocrine system.

I’m writing this in the hope of raising the issue of incognizance concerning thyroid diseases and the multimorbid patient. These patients are often bandied between different healthcare units. I’m asking all my colleagues, in particular our dear general practitioners and family physicians and also endocrinologists to have a broader perspective and to be more percipient when it comes to matters concerning the thyroid.

It’s important for me to write this book as I meet patients with thyroid problems almost daily, especially patients with Hashimoto’s disease. Patients who are desperate and confused. They feel bad when they can’t motivate how their underlying problem is the thyroid problem and that depression or other derived diagnoses are not the cause of their problems.

A patient who only has a high value of TPO antibodies, thyroid peroxidase antibodies, but normal values for other thyroid variables will have a hard time receiving a treatment, even though they have several related symptoms.

What’s interesting to me is that almost all patients that have been seeing another doctor before me, had undergone blood tests for the thyroid. When I ask them why their doctor had chosen to do these tests, they answer “when I told my doctor about my symptoms, the doctor said that we needed to do tests for my thyroid and then schedule a revisit”.

At the revisit with the doctor, if the tests results had been within the normal range, the patients will have almost no chance to explain that it is their hormonal system or their thyroid system that isn’t working as it should. The patients are told “you don’t have a thyroid problem but rather a psychological one, anxiety, depression or that you’re stressed out, that you have stress induced myalgia, gastritis” and so on.

The patient will then get the suggestion and recommendations to try antidepressants, pain relief with Paracetamol, morphine or morphine derivatives such as Citodon, Tramadole, tranquillisers against neuropathic pain such as Gabapentin and Pregabalin (Lyrica), anti-inflammatory substances such as Diclofenac (Voltaren), Ibuprofen, sedatives such as Atarax, Beta blocker (Inderal) or soporifics such as Zopiclone, Propiomazin (Propavan), Zolpidem and more.

If the patient isn’t satisfied with the symptom suppressing treatments above, they will be remitted to counselling with either a counsellor or a psychologist, a referral to a psychiatrist for possible prescription of other sedatives or alternatively SSRIs antidepressants (Selective Serotonin Reuptake Inhibitors) or remitted to pain, rehab, and fibromyalgia clinics. Sometimes they will also receive information about physiotherapy, aqua aerobics, and massage or possibly a referral to migraine and headache managements.

As time passes the patient who has not received a correct diagnosis or an effective treatment is instead being medicated to supress their symptoms. Often with difficult side effects as a result which according to my experience is because patients with thyroid problems are often very sensitive to several drugs. There is a major risk that this individual will feel worse both physically and mentally than she/he did before treatment began. During this phase, The patient may receive a new diagnosis, burnout syndrome and will require sick leave.

Syndrome means a combination of several symptoms and diseases which are not precisely related to a specific underlying reason. The patient will get desperate and start to seek help from other doctors and other clinics. The frustration of not being believed and the fight to prove your point and disprove your health care provider about how there is something else that’s wrong within body. That the cause of your symptoms is not in your mind or caused by stress which drains you of energy. The patient starts to collect information online and contacts others who have similar experiences. They often start to treat themselves with alternative drugs and supplements without having any prior knowledge about these products. They do desperate things in order to feel better.

It really hurts me as I’m writing this. A great many patients have told me that they have not been able to be honest with their doctors, but have had to lie about their prescribed medicine, such as Levothyroxine. All the while they are treating themselves. When I ask them as to why they’ve chosen to lie, the answer is that they don’t want to end up in a conflict with their doctor, that they don’t have the power to do so, and that the doctor doesn’t have an understanding for this or that they are dependent on the system and the doctor to be able to perform blood tests. Another important thing that I’d like to bring up is that most patients with thyroid problems are women. They’re often active and ambitious women who have been very successful in society; teachers, principals, journalists, entrepreneurs, politicians. Their condition has brought them to their knees. They have lost their jobs, lost benefits and have been denied insurance because of their disease. Some have had to separate from their partners and thus many have become single mothers, mothers without insurance and with limited financial resources. This makes everything even harder for them when they want to get help and the treatment from a private clinic. The disease doesn’t only affect one person, but rather it affects the entire family and the community. In this way society as a whole is affected by the major psychological and economic consequences.

If we really want to save money, and if we really care about the economy of the counties, I propose that the experts will raise this issue. I propose that they would include the cost of all the doctor’s visits that thyroid patients have around different clinics. That they include the cost of prescribed drugs, sick leave, mental illness, and the unemployment which goes together with this disease. The cost of legal matters and family disputes together with mental illness in children with a parent or parents with thyroid problems. It must be unremunerative to continue like this without treating the cause of this illness!

It would be desirable to conduct a study to research the correlation between the diagnoses burnout and hypothyroidism. This can be done by using the diagnosis code for burnout from the system with the help of a search engine, and then see if the patient is at the same time being treated with Levothyroxine.

I have no data other than my 23 years of experience as a medical practitioner and my own disease progression to support this statement, but I believe that a big number of the individuals who are on sick leave due to burnout today, have a hormonal problem as the real cause of their disease profile. To think of the number of individuals that we would have saved from suffering and how much our society would gain by treating these patients for the root causes of these problems and to not only alleviate their symptoms.

“A Sifo survey conducted on behalf of “Sköldkörtelförbundet” in 2018 shows however that every fourth patient (25 percent) receives no or very little symptom relief despite treatment. 60 percent, corresponding to more than a quarter of a million people, have remaining symptoms despite treatment. Only every third patient, 33 percent, gets rid of their symptoms either partly or completely. At the same time, statistics from the National Board of Health and Welfare show that only two percent of patients were allowed to try other alternatives when the standard treatment did not help”.

I understand that the medical community believes that more research needs to be done on the diagnostics and treatments before one dares to change the current standard treatment. But to be able to conduct evidence-based studies, an enormous number of resources are needed as everything involving diets and lifestyles requires long research periods and large test groups. There is a lack of companies that are willing to invest in in these studies, and as our public institutions have a hard time investing in big studies, I call for our doctors to be a braver and percipient. They need the opportunity to undergo continuous training and to be able to update their knowledge, especially within biochemistry and nutrition. Doctor’s also need the approval of their employers to be able to see the patient holistically instead of strictly following the guidelines. How dangerous can it really be, for example, to exclude certain foods from a patient’s diet?

One of my previous supervisors regarded the exclusion of foods containing gluten and dairy from the diet of a patient, with the intention of reducing inflammation, on par with quackery. I don’t agree…

That it so far has taken all this time to find the perfect cure or to find a treatment for hypothyroidism might partly be due to the lack of knowledge with practitioners and the public. Furthermore, it’s not possible to patent things related to diets and lifestyles which is why it’s not profitable to finance research within this field. Another reason that many of us have probably heard about is that hypothyroidism has been a female-dominated disease and the saying “the society invests less in women”. The first part however might not be 100% true as the case might be that symptoms men get have yet to be connected to this widespread disease. But it would be prudent to consider the possibility that type II diabetes can be the other side of the hypothyroidism, or that these two go hand in hand.

Type II diabetes is more common in men. This subject has been very interesting for the research and Big pharma during the last years.

If we have alternative medication for other diseases such as diabetes and hypertension, it should go without saying that other functioning drugs and treatments should be available for patients with thyroid diseases and hypothyroidism. The patient should have the right to choose their medical treatment other than being treated with Levothyroxine.

All the best,

Azin

* Some of the common brand names of Levothyroxine are Levaxin, Eltroxin, Euthyrox, Letrox, L-thyroxine, Thyrox and Synthroid.

Chapter 1

My Story

Chapter 1

My Journey to Become a Better Treating Physician

This is a part of my own story, and I’ve written this book based on my role both as a doctor and a patient.

A Beach in a Warm Country

It was a warm and sunny day in Spring. I was standing in the shade, deep in my own thoughts, watching my husband play Boules. I was also playing earlier in the afternoon, but the pain in my arm and shoulder meant that I could no longer play.

I was hiding in the shades because I couldn't stand being in the sun. Don’t get me wrong, in previous years I used to love being in the sunshine but now I was warm, boiling inside, and had a lot of pain in my entire body.

Yes, I was boiling like a volcano. I had gained about 8 kg in weight in the recent months. It was mostly water; I was sure of that, and none of the tests that I had taken was showing any kind of anomaly.

My health had deteriorated after the latest miscarriage a few months earlier. The symptoms had gradually been creeping in and became more and more intense.

After the first miscarriage a year ago, I had asked my gynecologist to take thyroid samples including TPO antibodies, as a few years earlier I had slightly elevated TPO antibodies.

It turned out that my antibody level had risen significantly, but according to the gynecologist, this was not a problem as I had very good results on the other thyroid samples. The miscarriage was blamed on the quality of the egg and chromosome failure during the first trimester. Okay, sure!

"You can try to get pregnant right after your first period", was the message from both my regular gynecologist as well as the other gynecologist we’d contacted to get a second opinion from. This surprised me, and my gut feeling told me to wait a couple of months before trying again. Another attempt was made that also ended up in a miscarriage.

What was the problem that caused these miscarriages? It was easy for me to get pregnant, but obviously something happened around week 7-8 during the development of the fetus. To blame it on the quality of the egg and our age which we were told time and time again was not enough for me.

By this time, I had started to feel very tired and had difficulties getting up in the morning. I became easily stressed and had anxiety attacks, off and on, that could get quite intense.

My work as a district family physician was stressful, especially working in a place with unreasonable expectations placed on me when I simply wanted to benefit my patients.

Several of my colleagues were feeling unwell. We probably switched workplace for a long-term functioning one had it not been for our good team cohesion. We were completely worn down by the workload, the errors in the system and the unreasonable expectations for ambulatory care.

When the second miscarriage happened, it was blamed on me being stressed and exhausted. I sought help from a colleague to be referred to a pain clinic. Pain all over my body and extreme fatigue in the mornings was something that I’d had for a few years, but it had never been as intense as now. My deep sleep often came early in the morning, and it was crucial for my energy later in the day. I had trouble sleeping at night and slept superficially if I even managed to fall asleep at all.

Previously I did not believe that seeking help from a pain clinic would be of much use to me, as I had followed my patients with chronic and generalized pain for several years. But now, I wanted to give it a try in hopes that new knowledge and strategies had been implemented into the system.

I was now referred to the pain clinic and was waiting for a call from the hospital. This itself took a couple of months because the referral was sent late from my colleague's clinic. Later, the hospital's pain clinic responded that since the pain medicine specialist also has a small clinic in Stockholm, the hospital wanted the referral to be rewritten and sent to this private clinic instead. Here I must ask, why couldn’t the hospital itself pass the referral on to the pain medicine specialist’s own clinic when the doctor in question was also employed at the hospital? This bureaucracy means that the patient must completely unnecessarily wait for weeks and months. I believe that this is where many patients and colleagues recognize themselves and understand what I mean.

It took a few more weeks for the new referral to reach the right recipient. In the meantime, the colleague I had sought help from suggested that I take part in a Mindfulness course and be part of a study for healthcare professionals. I accepted this with pleasure and great anticipation. The first time, we sat and listened to instructions and received information, following this, it was time for exercises. I sat with difficulty on the floor, had a mattress and a pillow under me but still, I couldn't sit still. My body went numb, and it hurt. I couldn't sit in the same position for more than a few minutes. The second time, we started with the exercises and, if I remember correctly, we began by focusing and concentrating on our big toes. That's when I started reacting. My body was pounding and pulsing, I had a fever. All the body parts that were in contact with the blanket or the floor went numb. The entire thing turned into pure torture. After an hour and a half, the exercise was finally over. I don't remember what the course leader said. What I remember is that I went to him after the exercises were over and said: "This course and study may be very good but it's not for me, at least not now. I think I have a serious illness that I have to deal with."

To be able to find the cause of my illness, I asked my doctor to do some tests that also included inflammatory markers. The values were all normal. I also took allergy tests for foods including samples for gluten and milk protein. Everything showed a negative result, no allergy.

But my TPO antibodies turned out to have risen even more since the gynecologist's last tests. Now they were above 900 (REF range < 35 IU/mL) with perfectly normal values for the other thyroid hormones. My doctor was perplexed and didn't know what else to do. Therefore, I contacted a well-known consultant at the endocrine clinic myself and asked him about my test results.

He was critical, changed the tone of his voice and asked why a test for TPO antibodies had been taken. His question surprised me very much and I asked the counter-question: why shouldn’t the test have been analyzed?

-"Well, because about 8-15% of the population has elevated TPO antibodies without this being related to a disease or to symptoms. They're just there! Since the other results look completely normal, we do not have to do anything until TSH starts to deviate and then you can begin to think of a treatment with Levaxin."

Because I in my role as a physician, I had an interest in pain symptoms and followed my pain patients closely, I had asked the same doctor the exact same question about 5 years prior to this conversation. The answer 5 years ago was the same answer as I got today. This was, in my opinion, very surprising considering that many patients still live with these symptoms today, and it had been several years since we last discussed this issue. My expectation was that the knowledge and treatment methods had developed since then.

His response made me very angry and to ensure there really was no new knowledge, I told him it was about a patient with repeated miscarriages.

"OK," he said. All right, but the patient has normal results on the other thyroid tests. If she starts to feel worse and gets different results, she can start with Levaxin or be referred to us."

In my opinion, it is completely insane to just wait and watch the thyroid gland gradually be destroyed. This was therefore not a good enough answer for me.

Back to what happened at the attending physician’s small private pain clinic.

The day finally came for my appointment at the private pain clinic. It was a lovely spring day and I had been looking forward to this appointment for a long time with high expectations. But I was met by an indifferent doctor. Honestly, I don't remember what the doctor was talking about, but the assessment was that I was suffering from stress-related (fibro) myalgia and pain. I asked for thyroid tests but was told to do them through general practitioners at the community health center.

When I think back to my situation today, I probably had other options to do the bloodwork, there were different ways to go about it than this one, but I was too tired and sick. At the same time, I believe that Somehow I wanted to keep my role as a patient in the system, to not be my own doctor. I also wanted to have everything documented in my medical records.

Around the beginning of Autumn, I had an appointment at the hospital's pain clinic and fibromyalgia unit. I don't think I'll ever forget that day. I had been at hospital grounds before, but on this day, I became completely disoriented on the way there. I didn't even know which way to go. My calves were swollen and hurt so much that I couldn't pull up the zippers of my boots. Confused, disoriented, unfocused and with severe pain in my body, I was pacing back and forth on the street until I managed to pull myself together and think clearly. The experience was terrifying, and I will return to this state later in the book.

The examination showed exhaustion, weakness and muscle pain but with normal test results. I took care of myself, any vitamin or mineral deficiency could not be the cause according to the attending physician. The test results were within the reference ranges. I was offered to take Saroten, Amitriptyline, an antidepressant. This drug was formerly called Tryptizole and was offered in a low dose to fibromyalgia patients. Tryptizole, which is deregistered in Sweden, was long popular with pain clinics and rheumatologists. I had a couple of patients, mostly women, who were on the drug. I remember looking at the doctor in shock and saying: “this is the same as Tryptizole and I am very unsure that it will have any effect”. The doctor who was kind and wanted to help replied: "yes, but it's new, give it a try". I had previously tried two different types of antidepressants for fibromyalgia with terrible side effects as a result. With one drug, I got such a loud tinnitus that I almost went deaf. With the second drug, where I took half of the recommended maintenance dose, I experienced severe abdominal pain and cramps in my body.

I replied to the doctor kindly, but also firmly, that I was not going to take out the antidepressant medication, let alone use it. My expectation for the examination may not have been great, but I had hoped for something new and a more sensible treatment.

A nice breeze at the beach shook me out of my thoughts. I looked at my husband and saw that an elderly couple, now two of our best friends, were on their way to see him. They looked happy and alert and wanted to play with my husband who was a bit uncertain. Maybe he wanted to quit playing. He looked at me, and I smiled. I looked at the couple, we smiled and nodded at each other. Right after, another man came, and they started to play in pairs.

After they finished playing, we introduced ourselves to each other, they were Dutch. The man asked me why I hadn’t been playing. My answer made him sad and pensive. He told me about how he was mindful of his diet since a decade back, after he had suffered from a heart attack. He could not understand how a person who ate healthy, played basketball regularly, never smoked, did not consume alcohol, and otherwise had a healthy lifestyle could suffer from a heart attack. However, his neighbor who was severely overweight, who did not care about what he consumed, did not move unless he had to and smoked lots of cigarettes, was fine. This question had bothered him so much that he had gone into depth on the issue. He had already written a book about this, and his focus was now on how diet and supplements could prevent cancer. The conversation came to be about vitamins and the impact of minerals on our well-being, and we immersed ourselves in the issue of vitamin D. I told him that for a few years now, I took a significantly higher dose of vitamin D than recommended but that my laboratory values were still not ideal.

I think I immediately understood that there was something special about him and what he was saying. It was above all two words that caught my interest, iodine and lectins. Iodine, how much did I really know about this mineral except that it was important for the thyroid gland and that it was previously used as a disinfectant.

He was very interested in the fact that breast cancer was more common in Dutch women than in Japanese women who take iodine at significantly higher doses. He said that the proportion of women with breast cancer had increased significantly in the Netherlands in recent years. According to him from about 1/10 to 1/3.

"Lectins, do you mean Leucin or Lecithin?". "None of them, I mean lectins from the plants" he replied. No, I didn't know anything about lectins, nor about the connection between gluten and milk which we started to discuss.

Fred and Annelies, a big thank you to you amazing people who passionately engage yourselves to help the others.

When we got back to Sweden, my husband and I sat down in front of the computer. We searched for lectins, iodine, fibromyalgia, and food allergies. All our free time was used for this, and we read article after article, study after study. It felt like we were turning the whole web upside down and thank God, eventually the pieces of the puzzle started to fall into place, one by one.

Throughout my life, I’ve always been interested in our diets and its impact on our health, but I had never before focused on the subject as we did now. A lot of things were familiar, but I hadn't put them in their real context.

I had heard about soaking, handling of food and what to eat from my grandmothers. I listened to them of course and was very curious as a child. But unfortunately, both passed away before I understood what they were really talking about.

As modern society developed at the end of the 20th century, new dietary trends, new eating habits and new additives began to emerge. Marketing of hundreds of products with different tastes, colors, and packaging. New oils, flavorings, dyes, texture agents and stabilizers. Our crops were resistance bred, fertilized and sprayed. The livestock was treated preemptively with antibiotics. All in order to be able to produce at a cheaper cost, and to be able to survive in the cut-throat competition that exists in the food industry. What had been learned about food handling through experience from past generations was gradually forgotten.

I started to reflect on my own diet and whether I had made any changes. Well, in the last few years my husband and I had started drinking 1-2 cups of hot chocolate with chili in the mornings. With it, we often had a cheese sandwich made with wholegrain bread. I had only occasionally used milk in small quantities in the past, either in tea or coffee that I sometimes drank. I sparingly used bread and grain products, and the gluten test was negative; could it be the milk? However, the allergy test for cow's and goat's milk was also negative.

I then decided to remove both gluten and milk temporarily, strictly from my diet.

Already after two weeks I felt that I was releasing water from my body, and after a month I had lost about 3kg in weight. I hardly ever had a fever and the pain in my joints decreased significantly. After about two months, I was much happier and more alert. Even my colleagues at the community health center noticed the change. They noted that my face was glowing and asked what was going on.

I had changed, but I was still powerless, and it numbed and hurt when I put a strain on a body part. The tendons in the joints were still sore. At the slightest load, I often had numbness and painful myositis, inflammation of the muscles, especially in my upper arm. For example, if I was going to hold the telephone handset, I had to switch hands after a few seconds to avoid the numbing.

A game of Boules, on a sunny sandy beach, followed by a stubborn search for knowledge initiated it all. That's a good start! I had at least removed the culprit that caused my symptoms, but it was not enough, that was not the whole picture.

Over time, I began to dig deeper into inflammation, autoimmune diseases, inflammation inducing diets, vitamin and mineral supplements, their function and the body's absorption of nutrients. All this I will tell you more about during their respective chapters in the book, and why diet is fundamental in the treatment of inflammation and inflammatory thyroid diseases.

Chapter 2

Food and Inflammation

Chapter 2

Foods That May Cause Inflammation

”Let food be thy medicine, and medicine be thy food”

Hippocrates, founder of medicine 400 BC

This quote, attributed to Hippocrates, has long been framed on the wall of my office as inspiration to my patients.

Almost all the patients that I have met have had the attitude that they already have a good understanding of the food that they eat, and that they eat healthy.

But do we really have enough knowledge about the food that we consume? Do we really know what our body needs and doesn't need? How much do we know about evolution in nature and in the plant kingdom?

We know that a diet that works for one person may not work for another. Because if that was not the case, one diet would be enough for all of us, and the newspapers would not have to write about all these different diets.

I have met many children and young people, especially girls between the ages of 9 and 10, who have become vegan without having any knowledge of nutrition and diet.

Diet and nutrition are two different things. Being on a specific diet does not necessarily mean that the diet contains all the nutrients the body needs.

I have studied nutrition for years, but I'm still learning new things every day.

Therefore, it is very important to talk about nutrition and about harmful substances that end up in our body through food as well. This is fundamental to our health and especially to the functions of the thyroid gland.

I want to begin with the intestines and explain how the harmful substances can cause problems in the body when they end up in our cells and organs.

A Healthy Human Has Healthy Intestines!

A Leaky Gut

What does a ”leaky gut” mean?

Everything that we eat passes through our intestines. Their main purpose is to absorb nutrients, but they also have other important functions. About 80% of our immune system is in our intestines and it is largely managed by our gastrointestinal microbiome. Our intestinal bacteria perform a vital and amazing job. They protect us, break down the food for an easier absorption and form hormones and neurotransmitters. They prevent overgrowth of harmful bacteria and much more. Did you know that the bacteria in our guts contributes to the formation of the happiness hormone serotonin and that our good intestinal bacteria are damaged by chronic stress? In other words, people with chronic stress are very prone to having lower numbers of good bacteria in their intestines and thus a low level of neurotransmitters such as serotonin. Low levels of serotonin cause symptoms such as anxiety, distress, and sleep disorders. This is an example of how our gastrointestinal microbiota communicates with our brain 1, 2. I can recommend the book "Save Your Brain Now" written by brain scientist Dr. Hayde Bolouri PhD and Peter Wilhelmsson ND.

Our intestinal cells are held together through a binding called tight junctions. When our intestinal flora is exposed to toxic substances such as toxins from a bacterium, harmful substances in the food such as certain additives and heavy metals, lectins or gluten, the intestinal cells will become inflamed. This inflammatory process dissolves the bonds and creates openings between the cells causing the intestine to leak.

The use of NSAIDs, non-steroidal anti-inflammatory drugs, such as Voltaren, Diclofenac, Naproxen, also increases intestinal permeability and allows toxins and harmful substances to enter the blood circulation.

My own illness and the experience of my patients have led me to adopt the following theory. When the harmful substances leak from the intestine into the bloodstream, they gradually end up in other organs and cells. This in turn can contribute to an inflammatory process which signals the immune system. The immune system forms antibodies against the cells in which the foreign substances have bonded. The immune system no longer recognizes these cells as part of the body and wants to fight the intruder. In other words, it is the foreign substances that cause an inflammatory process by activating our own immune system against our own cells.

Figure 1. The Leaky Gut

In my opinion, this process is one of the reasons for autoimmune diseases, but more research is needed in this area. I have been able to confirm this theory by looking at my own symptoms and those of my patients during consumption and elimination of certain foods.

A person with inflammation in the body can have one or more inflammatory diseases at the same time. For example, those with Hashimoto's thyroiditis may have autoimmune gastritis, rheumatoid arthritis (RA) and inflammatory bowel disease (IBD) as well. I believe that the lectin and the harmful substances that leak into our body through the intestines first target our glands. While following up on my patients, I have met many who have problems with the thyroid gland, pancreas, liver, adrenal glands, prostate, breasts, and ovaries. If the disease becomes tangible and progressive, it can ultimately contribute to cancers such as breast and prostate cancer.

Food Allergies

Now that we have gone through the mechanism of a leaky gut, we can also understand how harmful substances can affect our immune system and our health. These substances can create food allergies or intolerance. It is not uncommon that a sensitivity to several substances develops.

The body can get sensitive, and these reactions can occur without necessarily finding antibodies to allergens. None of my patients who reacted to gluten, including myself, had positive gliadin/gluten transglutaminase antibodies according to the lab results. In contrast, several of the patients had an increase in TPO antibodies.